LEROY WILSON GLENN

LEXINGTON, NC
NPI1831243054
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC  688)
Enumeration Date2007-01-23
Last Update Date2007-07-08
Business Address
-- LEROY WILSON GLENN LCAS
220 EAST FIRST AVENUE EXTENSION SUITE 10
LEXINGTON, NC 27292-3355
Phone number: 336-242-2450
Mailing Address
-- LEROY WILSON GLENN LCAS
1404 SANTOLINA LN
LEWISVILLE, NC 27023-8622
Phone number:
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